GOVERNOR Workforce Committee Meeting June 25, 2015 Committee - - PDF document

governor workforce committee meeting june 25 2015
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GOVERNOR Workforce Committee Meeting June 25, 2015 Committee - - PDF document

EXECUTIVE CHAMBERS HONOLULU DAVID Y. IGE GOVERNOR Workforce Committee Meeting June 25, 2015 Committee Members Present: Guests: Beth Giesting, Co-Chair Sally Pestana (attending on behalf of Patricia OHagan) Kelley Withy, Co-Chair Peter


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State of Hawai‘i, Health Care Innovation Office | Page 1 of 4

EXECUTIVE CHAMBERS HONOLULU DAVID Y. IGE

GOVERNOR

Workforce Committee Meeting June 25, 2015 Committee Members Present: Beth Giesting, Co-Chair Kelley Withy, Co-Chair Laura Reichhardt Jillian Yasutake Susan Young Robin Miyamoto (via teleconference) Gregg Kishaba Staff Present: Joy Soares Trish La Chica Abby Smith Nora Wiseman Guests: Sally Pestana (attending on behalf of Patricia O’Hagan) Peter Alexandratos (attending with Kelley Withy) Committee Members Excused: Catherine Sorenson Christopher Flanders Helen Aldred Lana Kaopua Deb Gardner Lynette Landry Celia Suzuki Aurae Beidler Carl Hinson David Sakamoto Dan Domizio Christine Sakuda Deb Birkmire-Peters Forrest Batz Jane Uyehara-Lock Josh Green Katherine Parker Mary Boland Nancy Johnson Napualani Spock Roseanne Harrigan Shunya Ku’ulei Arakaki Call to Order and Introductions:

  • Dr. Withy thanked everyone for attending and participating in workforce planning. Members introduced

themselves and stated their respective organizations of affiliation

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Hawai’i Health Care Innovation Models Project Work Force Committee Meeting June 25, 2015 State of Hawai‘i, Health Care Innovation Office | Page 2 of 4 DLIR Appropriation: 

  • Dr. Withy provided background information regarding the development of a central health

workforce center

  • Brief mention of plans for determining what the center would do, where it would be housed,

and how it would be funded 

  • Dr. Withy discussed the introduction of HB 696 to create a Health Workforce Advisory Board, in

addition to Information Technology and Agriculture Boards  Total monetary allocation for the collective Boards in 2016 is $400,000  Jillian Yasutake identified the purpose, scope, and direction for the Health Workforce Advisory Board

  • Board’s imperatives include policy planning and skill panels building
  • Representatives from the Department of Labor, public health sector, UH system, Community

Colleges, nursing sector, and HHC will comprise the Board

  • Subcommittees for education and training purposes could be established, and include

participants from outside resources Project ECHO: 

  • Dr. Withy discussed the Project ECHO history, based on the pilot in New Mexico

 Education and tele-monitoring offered to healthcare providers using distance for 1.5-2 hours a week

  • n topics to be identified as most needed by rural providers. Dr. Withy will be adapting a Project

ECHO program for Hawaii

  • Participants from Hawaii State Rural Health Association will be traveling to NM for a three

day, funded by State Office of Primary Care and Rural Health

  • Training will be provided in the areas identified as most needed by survey of Hawaii provides

and could include Hepatitis C, child health, and addiction, as well as many others.

  • Plans to survey healthcare providers in Hawaii, especially those in rural settings, to ascertain

which areas of ongoing continuing education would be most helpful

  • Survey to include representation among the Department of Corrections and community

health centers

  • Recruit specialists and volunteers from the pharmacy, social work, addictions, hepatology,

and infectious disease fields to provide ‘train the trainer’ series

  • PhD student enlisted to develop the survey, into which he will build assessment measures

for prospective cost savings State Innovation Model (SIM) Grant: (Please see attached slides for more detail) Co-Chair Beth Giesting provided an overview of SIM process:  Health care innovation/transformation started with stakeholder convening in 2012  SIM Round 1 was carried out in 2013 with stakeholder engagement, broad in administration and high level in conceptualization  SIM Round 2 provides the opportunity to create a more finely tuned implementation plan, more narrowly focused  All Payer Claims Database (APCD) and No Wrong Door (through the Executive Office on Aging) are also working parallel to SIM  SIM 2 continues to focus on the Triple Aim +1 Goal: Better Health, Better Care, Cost- Effective Care, and the +1 for Hawai’i, which is to reduce health disparities  SIM 2 Targets: behavioral health integration with primary care and oral improvement via increased access

  • Focus on Medicaid: Judy Mohr-Peterson will soon begin as the new Medicaid

Administrator

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Hawai’i Health Care Innovation Models Project Work Force Committee Meeting June 25, 2015 State of Hawai‘i, Health Care Innovation Office | Page 3 of 4  Rationale for Target Populations:

  • Based on feedback from SIM 1, BH integration presented as the most

important element to underscore innovation initiatives

  • Currently, BH conditions disproportionately affect the most vulnerable

populations, and BH has been absent from innovations to date

  • It is worth noting that total healthcare expense estimates for those with

Behavioral Health conditions cost three times more than those without BH conditions  SIM 2 grant ends January 31, 2016 SIM 2 Action Plan: (Please see attached slides for more detail) SIM Director Soares gave an overview of the current SIM Process:  A total of six (6) committees provide guidance to SIM: Steering, Delivery & Payment, Health IT, Workforce, Population Health, and Oral Health  The operational plan in development spans a five-year period  At each committee meeting, members will be informed about what other committees are working

  • n, and offered an opportunity to provide feedback

SIM 2 Stakeholder Engagement:  Focus Groups:

  • Nine (9) focus groups will be led by Dr. Withy with behavioral health and primary care

providers to commence in July, across all islands  Community conversations:

  • Community meetings will take place on all islands in August or September, to solicit

feedback regarding direction and plans  Website is now active through the Governor’s webpage: http://governor.hawaii.gov/healthcareinnovation/

  • This affords an opportunity to contribute feedback regarding the draft innovation plan

 SIM 2 Decision-making workflow

  • Committee members work together to achieve consensus
  • For any questions regarding membership, email Joy Soares at joy.soares@hawaii.gov

Workforce Objectives:  Support “emerging” professions and expand primary care team

  • Community Health Workers
  • Community Pharmacists

 Identify strategies increase availability of behavioral health professionals  Develop plan to support primary care practices

  • Training for primary care practices (e.g. screening tools such as SBIRT)
  • Telehealth consults for BH
  • Learning collaboratives

 Expand telehealth

  • Identify opportunities

 Interprofessional training Questions:  What is the timeline for SIM SHIP?

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Hawai’i Health Care Innovation Models Project Work Force Committee Meeting June 25, 2015 State of Hawai‘i, Health Care Innovation Office | Page 4 of 4

  • Plan is due January 31, 2016
  • SIM will share work from the other committees to keep everyone informed

 Learning collaboratives for ongoing training and education

  • Even if we equip providers with the tools, to whom do we refer for services?
  • Shortage of behavioral health providers
  • Issues of cultural competency among providers

 Roles of CHWs and community pharmacists?

  • Engage patients in compassionate care, conduct SBIRT, motivational interviewing,

provide teaching, support, advocacy  Could we convert one of the nine focus groups to a patient feedback group?  Residency and/or internship programs to staff remote settings? Next Steps:  Continue discussion about workforce goals, strategies, and resources

  • Planning and progress toward SIM SHIP deadline

 Future meetings will continue to take place at the State Office Tower, Room 1403  Parking passes are available for space in State lots  Contact Nora Wiseman at nora.c.wiseman@hawaii.gov or 808-859-0674 to request passes in advance

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State Innovation Model Design 2

WOR ORKF KFORCE C COM OMMITTEE EE JUNE 25, 25, 201 2015

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Welcome and Introductions

  • 1. Kelley Withy, AHEC (Co-Chair)
  • 2. Beth Giesting, Office of the Governor (Co-Chair)
  • 3. Helen Aldred, Kaiser-Permanente
  • 4. Shunya Ku'ulei Arakaki, AHEC
  • 5. Forrest Batz, UH School of Pharmacy
  • 6. Deborah Birkmire-Peters, Pacific Basin Telehealth

Resource Center

  • 7. Mary Boland, UH SONDH
  • 8. Dan Domizio, Hawaii Academy of Physicians Assts
  • 9. Christopher D. Flanders, HMA

10.Deborah Gardner, Consultant and Advocate 11.Nancy Johnson, Maui College 12.Josh Green, Hawaii IPA, State Senate 13.Rosanne Harrigan, UH JABSOM 14.Carl Hinson, Hawaii Pacific Health SIM Staff: Joy Soares Trish LaChica Abby Smith Nora Wiseman

  • 15. Lana Kaopua, UH School of Social Work
  • 16. Gregg Kishaba, DOH
  • 17. Lynette Landry, Hawaii Pacific University
  • 18. Robin Miyamoto, JABSOM/UCERA
  • 19. Patricia O’Hagan, Kapiolani CC
  • 20. Laura Reichhardt, Center for Nursing
  • 21. David Sakamoto, Consultant and Advocate
  • 22. Christine Sakuda, HHIE
  • 23. Catherine Sorensen, DOH
  • 24. Napualani Spock, HPCA/Rural Health Association
  • 25. Celia Suzuki, DCCA
  • 26. Joan Takamori, Public Health Nursing
  • 27. Jane Uyehara-Lock, UH
  • 28. Jillian Yasutake, DLIR
  • 29. Susan Young, UH West Oahu
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Review: 2012 - 2014

  • Hawaii

Healthcare Project

  • Learning

Sessions

2012

  • SIM 1
  • Stakeholder

Consultation

  • Health

Summit

2013

  • SIM 2

Priorities

  • ACA, NWD,

APCD

  • Transition

2014

  • Getting started
  • PCMH, ACO, Care

Coord.

  • Expanded

discussions

  • High level plan
  • 6 Catalysts
  • SIM 2 Proposal
  • Associated projects
  • New Governor
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SLIDE 8

SIM Goals

Triple Aim + 1

  • Better health
  • Reliably good quality care
  • Cost-effective care
  • + Reducing disparities in health status and access to care
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SLIDE 9

SIM Initiative

SIM is based on the premise that state-led innovation, supported by broad stakeholder input and engagement, will accelerate health care delivery system transformation to provide better health and better care at a lower cost. SIM encourages public and private sector collaboration to design and test multi-payer models to transform the health care systems in the state.

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SIM2 Targets

Behavioral health integration with primary care – effective awareness, diagnosis and treatment

Adults with behavioral health needs Adults with chronic conditions in combination with behavioral health conditions

Oral health improvement via increased access to timely and preventive services

Access for children and increase dental sealants and fluoride varnishes Strategies to increase coverage for low-income adults

FOCUS IS ON MEDICAID

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SLIDE 11

Rationale for Target Populations

 Feedback from stakeholders, providers, community.  BH conditions disproportionately affect the most vulnerable populations.  While transformation in Hawaii is progressing, BH has largely been left out of innovations.  CHNA identified mental illness as number one preventable cause of hospitalization in 2012.  SIM Round 1 actuarial analysis showed the average total cost for individuals with a BH diagnosis was three times the average total cost for individuals without a BH diagnosis.

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Rationale for Target Populations

 Mental illness is a co-existing condition for 34% of potentially preventable hospitalizations and almost 10% of hospital readmissions (SIM HHIC analysis)  Total annual costs associated with potentially avoidable stays/visits (SIM HHIC analysis):

  • ER: $93 million (charges)
  • Preventable hospitalizations: $159 million (estimated cost)
  • Readmissions: $103 million (estimated cost)
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SIM 2: Developing a Plan of Action

Committees

 Steering  Delivery & Payment  Health IT  Work Force  Population Health  Oral Health

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SIM 2: Stakeholder Engagement

Provider focus groups – facilitated by Dr. Kelley Withy

Focus groups on all islands Final report submitted by September 30th

Community conversations

Meetings on all islands Report completed by October 31st

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SLIDE 15

HCI Website

  • The Hawaii Health Care Project (hawaiihealthcareproject.org) is no longer

being updated

  • Governor’s Office to host HCI content (http://governor.hawaii.gov/)
  • Program updates
  • Agendas, minutes, meeting materials
  • Opportunity to provide feedback
  • Resources and reports
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Steering Committee

Delivery & Payment Committee HIT Committee Workforce Committee Oral Health Committee

State Innovation Plan

Population Health Committee Innovation Director Finalizes, Submits

Support by Health Innovation Program Staff, Governor’s Office

SIM 2 Decision-Making Workflow

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SLIDE 17

SIM 2: Developing a Plan of Action

All-Committee Meetings

 SIM Kick-Off with Bruce Goldberg - May  Initial SHIP Draft and Committee Check-In - September  Structure & Sustainability Plans - November  Final SHIP Celebration and Next Steps - January

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SLIDE 18

CHW Training Program Update

SIM team meet with Patricia O’Hagen and CC staff to discuss training curriculum Next Steps Beth Giesting will ask Judy Mohr Peterson, the new Medicaid Administrator, for a meeting to discuss CHW reimbursement options Stakeholders will meet with Judy to discuss CHW training program and reimbursement options SIM team and Patrica O’Hagen’s team will identify key decision points and timeline, and solicit feedback WF Committee

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Workforce Committee Goals/Targets

Support “emerging” professions and expand primary care team

Community Health Workers Community Pharmacists

Develop plan to support primary care practices

Training for primary care practices (e.g. screening tools such as SBIRT) Telehealth consults for BH Learning collaboratives

Expand telehealth

Identify opportunities

Interprofessional training

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SLIDE 20

Next Meeting

Thursday, July 23rd from 3:00-4:30pm – location TBD